Closing 2017 - Ringing in 2018!

This December, we post some closing thoughts from people across the organization - together, we share pride and gratitude for the strides we as a company have made to benefit communities nationwide. Let 2018 bring greater progress toward a future where everyone has access to oral health, without exception.

I’ve never been more excited about the future of our enterprise. With strategic change and the work of the entire team we are able to drive both social and economic value to help us meet our mission-  to improve the oral health of all. -- Steve Pollock, President & CEO

It is a great time to be part of DentaQuest – our future does look bright! -- John C.

Educating and serving the communities we live… feels great to be part of the Team! -- Fatima

I am very thankful to have a wonderful Boss and Leadership team overall. I am thankful for my family and friends. I am thankful for my continued good health.May you all be safe during this Holiday Season. -- Diana S.

Great job to everyone in this organization that works so hard to ensure we offer the best customer experience possible. A special shout out to the customer service team that is on the front lines with our members and providers every day. - Angela K.

Looking very forward to 2018 and continuing to grow and evolve our organization!! -- Bill P.

Looking forward to an exciting New Year in 2018 with DentaQuest and our new (and existing) Leaders!! Happy Holidays Everyone!!! -- Susan H.


Look for a new blog location in 2018! Oral Health Matters, which remains a key part of our ongoing oral health conversation, is moving ... stay tuned and stay safe. From all of us at DentaQuest

A Quality Improvement Director Goes to the Forum...

This week, staff from DentaQuest’s Institute attended the 2017 Institute for Healthcare Improvement (IHI) Forum. During this multi-day conference, healthcare professionals from around the globe meet in Orlando to talk healthcare improvement. While oral healthcare is not a prominent discussion topic, DentaQuest has been attending since 2011. 

At Monday's pre-conference Scientific Symposium, Dr. Natalia Chalmers and Quality Improvement Project Manager Carrie Peltier presented a poster on our Dental Caries Management (DCM) Collaborative results (pictured left). Over 200 posters were submitted for consideration; the Institute’s poster was one of 70 - and the only one on oral health - chosen. Dr. Chalmers commented that the buzz about the importance of good oral health being vital to overall health was inspiring. Many wanted to learn more about the DentaQuest approach.

The general session featured a series of keynotes and 200+ workshops topics covering improvement science, joy in work, leadership, population health, person-centered care, safety, moving from volume to value to name a few. 

This year’s Forum opened from the lens of patient experience. The keynotes challenged care teams to create a bidirectional transfer of knowledge between patient and care team; this is, in fact, an act of caring. Care teams must work to create this space. It truly matters. Keynote Tiffany Christensen commented: we must ask generous questions to know and learn what matters to our patients. Our job is to make sure there is equity. These sentiments very much resonate with the Institute.

Later in the afternoon, we heard from Bryan Stevenson, a social justice advocate. Mr. Stevenson powerfully reminded us that it is our duty to create healthier communities. We must get closer to the poor and to communities that have been marginalized, neglected, and isolated. There is power in proximity. We also need to change the narrative that defines the difference of race. We must stay hopeful, as our hope has to fuel our practice. And lastly, we need to do the things that are uncomfortable. We have to make the choice to do the difficult thing.

General Stanley McChrystal shared his Team of Teams vision. He spoke about organizational change; being at an inflexion point and ready. He talked about ‘shared consciousness,’ meaning to connect on something with purpose and time and focus. “Together we need to project 'this place' where we want to go and make it to fruition.” This requires leadership that composes self-awareness, discipline, decision making, effective communication, connection, constant learning and functional excellence.

Lastly, as is IHI tradition, we heard from Dr. Don Berwick, president emeritus and senior fellow at IHI. Dr. Berwick’s spot-on remarks and reflections on the American healthcare system ring true year after year, and this year was no different. He shared a moving personal story of needing - and using - the healthcare system for his own family. He charged organizations to “snuggle,” meaning outline a clear and common purpose, be all together, or none at all and provide a safe vessel – failures are instructive; it’s OK to try, there can be shared honor, and we must have affection and mutuality. As this culture is what saved his brother.

Healthcare is complex; like the organizations who provide care and coverage. Inter-organizational competition is not the answer; coordination is. And DentaQuest is no different. Leaving this year’s Forum, I couldn’t help but board my plane back to Boston with some puffed feathers … DentaQuest has these pieces. We are prime to be the ‘Leading Voice.’ Improvement work is a social thing. It asks us to reflect, to adjust, to learn from, and to collaborate. It demands that we ask is what we are doing better or more of the same? We want better; we want to improve the oral health for all. That means understanding the system, at the macro, meso and micro levels. All together, or none at all. We must always ask “what do we want to learn over time?” and chart that course.

Cheers to another amazing Forum. Kaiser Permanente sent over 400 staff this year. Won’t you consider joining us next December in Orlando? This stuff matters!

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Cindy Hannon, MSW

Quality Improvement Director 

DentaQuest Institute  

"When you believe in this stuff, it is easy to write!"

Hispanic Heritage Month: Highlighting two organizations committed to oral health

As part of our commitment to meeting the different oral health needs for different populations, DentaQuest learns about cultural heritage through observances like Hispanic Heritage Month, which runs through Oct. 15. It is a month-long tribute to Hispanic Americans who have so richly contributed to our society, and to the cultures, languages, and traditions passed down by their ancestors. DentaQuest is committed to improving health equity and advancing solutions that meet the needs of the many different people our plans and services touch, in part by supporting the efforts of local organizations.

While the contributions of our Oral Health 2020 network partners are as diverse as the communities and the perspectives they represent, and impactful in so many important ways, we’d like to take a moment to acknowledge two of our grantees who are working in this way to improve the public’s perception of oral health, and bringing the voice of Hispanic and Latino* communities to the table.

We know that the only way to develop targeted solutions and ultimately achieve better oral health for all is to engage those people who are most impacted. One of the goals of Oral Health 2020 is to improve the public’s perception of the value of oral health. We want everyone, not just dentists and hygienists, to recognize and understand the importance of the health of the mouth to the health of the rest of the body. With this important understanding, we will continue to mobilize communities across the country to rally together to advocate for better oral health.

In California, Vision y Compromiso is committed to improving community well-being by supporting promotores (liaisons between their communities and health and social service providers) and community health workers. Across 24 counties from Southern California to the Greater Bay Area, Vision y Compromiso’s network of promotores and community health workers is serving as a bridge for both native-born and immigrant people, and leveraging their shared language, ethnicity, culture, and experiences to reduce barriers to care and education. 

For example, together with Asian Americans Advancing Justice, Vision y Compromiso is spreading a campaign to educate individuals and families in the state on the health coverage available to anyone in the state, regardless of income or immigration status.  In just under two weeks, Vision y Compromiso will be bringing together these important stakeholders at their annual conference in Ontario, CA.

Also working on the West Coast is Latino Coalition for a Healthy California (LCHC). LCHC is one of the leading voices for Latino health in California, with a focus on initiating and advancing policies that help build healthy communities. With their ongoing work to address disparities in oral health, LCHC is focusing efforts on ensuring that affordable dental care is accessible to all Californians. 

Like Vision y Compromiso, LCHS is also working with promotores, training them to be both advocates and messengers for oral health and its social influences in Latino communities. LCHC is committed to elevating the voices of those in their communities to be heard by decision- and policymakers, in order to improve oral health at a systemic level. A recent initiative champions efforts that reduce access to sugar-sweetened beverages, which not only impact oral health, but also contribute to the disproportionately high incidence of diabetes in both adults and children in Latino communities.

We are so proud to support these and so many other amazing organizations that are working to improve the oral health of all. Please visit their websites to learn more:

Vision y Compromiso  

Latino Coalition for a Healthy California

*While “Hispanic” and “Latino” are often used and understood interchangeably, “Hispanic” focuses on Spanish-speaking origin, while “Latino” refers to people of Latin American origin.

Children's Health Insurance Program (CHIP) is vital for kids' wellbeing

September is a big month for kids – not only are they starting or heading back to school, but this year they also are taking center stage in Washington as Congress heads back from its own summer recess. Funding for the Children’s Health Insurance Program (CHIP) will expire at the end of September, meaning Congress must act swiftly to ensure continued, comprehensive medical and dental coverage for our nation’s children.

Nationwide, CHIP covers approximately 9 million uninsured kids (and in some cases, pregnant mothers) in families with incomes that are modest but too high to qualify for Medicaid. 

States administer the CHIP program in different ways. Your state may have a separate CHIP program, combine the CHIP and Medicaid programs, or include CHIP within Medicaid expansion initiatives. Although administered by states in a variety of ways, the federal government provides matching federal funds to all states and that funding is vital to the program’s continued success.

Historically, CHIP reauthorization and funding have enjoyed bipartisan support, with members of Congress working together to guarantee health care coverage for vulnerable children. However, with the hotly-contested debates over Affordable Care Act repeal and replace legislation, securing the future of the CHIP program may prove significantly more challenging this time around…

Congress must tackle a significant number of important issues in short order this September. 

Addressing the debt ceiling to avoid a government shutdown, authorizing Hurricane Harvey relief, and handling a Trump administration proposal to privatize air traffic control are all at the top of the list. But Congress cannot lose sight the importance of CHIP. 

Without a long-term solution, states will be left with uncertainty over the future of their health care programs for kids. If CHIP funding is not renewed, or not renewed by the end of the month, states will be forced to make difficult decisions regarding the enrollment of the children in their programs. Without this funding, some children will be left without any form of medical or dental coverage.

We have seen over time that coverage leads to care and access to appropriate dental care is vital for children. In particular, tooth decay, the most common chronic disease among children, is degenerative without treatment and prevention, and research shows poor oral health impacts school performance and attendance.

But CHIP’s importance extends beyond oral health. 

For example, recent research indicates that treatment of gum disease can lead to better overall health management—as evidenced by lower health care costs and fewer hospitalizations—among people with common health conditions, such as type 2 diabetes. Ultimately, Congress must understand the gravity of their decision – coverage for children positions them well for a lifetime of optimal health and success. Don’t let politics put this at risk. Instead, let’s collaborate across party lines to quickly develop a sustainable plan that provides effective coverage for children and mothers in CHIP.

September 2017 marks the start of school and the start of what could make or break our children’s futures. This month is about ensuring our next generation is well-positioned to achieve optimal health throughout their lifetimes. As an organization committed to improving the oral health of all, DentaQuest strongly urges Congress to work together on CHIP funding and reauthorization in time to protect these vulnerable populations.

Make sure your voice is heard! 

Look up your Representative or Senator and ask them to renew CHIP funding and support long-term, sustainable solutions to protect our children’s health care.

‘Action for Dental Health’ in Congress

While we all paid close attention to health care in the Senate last week, the House Energy and Commerce Committee made a critical, yet mostly overlooked step to advance oral health for at-risk populations.

On July 27^th, the Committee unanimously passed HR 2422, or the Action for Dental Health Act of 2017. This bill calls for Congress to authorize additional oral health promotion and disease prevention programs to help at-risk populations struggling to obtain appropriate oral health care.

The bill points out that more than 181 million Americans will not see a dentist, but almost half of people ages 30 and older have some form of gum disease and nearly a quarter of children under age 5 already have cavities. 

As we at DentaQuest well know, caries is the most prevalent chronicdisease among children and can be prevented. What’s more, we see time and again that Americans of all ages are in desperate need of access to oral health care - Missions of Mercy like the one in Wise County, Va., is a great example. Both the Washington Post and The New York Times covered the July event, for which thousands of people come from miles away and lineup for hours and even days just to get access to dental and other services.

If this new legislation passes through Congress, the Centers for Disease Control and Prevention will award grants and collaborate with states, counties, public officials, or other stakeholders to implement a variety of initiatives.

These activities could include oral health programs that:

·         more broadly use portable/mobile dental equipment;

·         facilitate the establishment of dental homes;

·         eliminate geographic, language, cultural, or other barriers to care;

·         reduce the use of emergency departments for dental conditions; and

·         provide dental care to nursing home residents.

It is exciting to see bipartisan support for dental care initiatives that have tremendous impacts on the oral and overall health of patients. This type of work will drastically improve the health of Americans. And it has the ability to address the estimated $2.6 billion in free care that dentists currently deliver, as well as the nearly $2.1 billion spent on dental cases in hospital emergency departments – 80 percent of which could be treated in a dental office for roughly $4 million total, according to the bill.

Bipartisanship like this must continue and we urge legislators to make oral health a critical component of any health reform legislation that passes through this Congress. 

DentaQuest Foundation grassroots grantees ready to leap for oral health

I recently heard the perfect analogy for our oral health advocacy during the DentaQuest Foundation’s Grassroots Engagement Strategy annual meeting. It’s a saying gardeners have about the growth process of perennials: “The first year they sleep, the second year they creep, then the third year they leap!”  This year is the year for the grassroots organizations and their partners to leap!

DentaQuest Foundation’s Grassroots Engagement Strategy started in March 2015 as an initiative to engage those most directly impacted by oral health inequities. Focused in six key states - Arizona, California, Florida, Michigan, Pennsylvania, and Virginia - the Grassroots Engagement Strategy leverages an existing network of key oral health advocates and stakeholders operating at the state level. The DentaQuest Foundation has funded 20 community-based organizations within these states to provide oral health outreach and take action on social justice and oral health equity, all with the goal of improving public perception of the value of oral health in their communities.

These 20 grantees represent deep and diverse experience working directly with community members and contribute essential perspectives of community advocacy and action. They are providing community-grounded voices within a broad group of stakeholders at the state, regional, and national levels, a perspective that is critical if we are to reach our mission of improving oral health for all.

The Grassroots Engagement Strategy has now entered its third year of development, and the purpose of the annual meeting this spring was for grantees to learn from one another about what has been accomplished in the last year, what is planned for the year ahead, and how to deepen the commitment to health equity.

On day one, each organization presented its community-driven plan that covered stakeholders, how they have incorporated the Oral Health 2020 goals into their communities, 2017 organizational priorities, their proudest moments, and their greatest challenges.

For example, one organization discussed advancing a legislative advocacy strategy around protecting oral health equity policies, while dealing with the major challenge that oral health is not a top priority for the community members facing other economic and social challenges.

On day two, many of the Oral Health 2020 national advocacy partners presented the resources and tools in development that will support the grassroots organizations in their work. Attendees also discussed how they can learn from one another and build their capacity to make change at the community level.

Additionally, there were presentations on different approaches to advocacy and lobbying, including how to provide empowerment opportunities for community members in advocacy and public policy.  Partners also discussed how they work collaboratively with other organizations to activate coalitions and networks that share common goals.

The underlying themes throughout the discussion:

• health equity 
• the link between oral health and other social determinants of health 
• the implications that these have 
• who  needs to be at the table  

Similar to previous years, the grassroots organizations returned home with a sense of rejuvenated momentum for oral health.   Words like “motivated,” “energized,” and “connected” were used by attendees format the close of the meeting.  With the political landscape changing, the role of grassroots organizations engaging in advocacy is even more critical at the local, state and national levels.

When community members are educated on the topic of oral health and have the passion and understanding of its impact, their voices are powerful.  

The Oral Health 2020 Network is excited to see the progress that will continue in these communities and beyond. The grassroots grantees are ready to “leap” into action for year three of the Grassroots Engagement Strategy!

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Guest post from DentaQuest Foundation's grants team member Liana DiRamio. Learn more about the grants and programs here: http://dentaquestfoundation.org/about/our-mission. 

DentaQuest Remains Voice for Oral Health Equity in Disparities Leadership Program

For the second straight year, DentaQuest is participating in the Massachusetts General Hospital’s Disparities Leadership Program. Last year, DentaQuest became the first oral health organization to be accepted into the program. Over the next 12 months, we will build upon our previous efforts to promote oral health equity for Medicaid and CHIP populations.

The Robert Wood Johnson Foundation recently released a paper that defines health equity as “the ethical and human rights principle that motivates us to eliminate health disparities,” both a process and an outcome.

Now in in its 11th year, the program gathers a variety of health care leaders to develop strategies that address disparities in health care. We are particularly excited to remain part of this team, which is designed to cultivate leaders who can align equity efforts with the transition to value-based health care.

DentaQuest is one of five health plans in this year’s class and once again the only oral health organization. Our project will focus on how to leverage data and our national footprint to identify and alleviate oral health disparities, while also promoting equity as a key objective for our own organization.


Why is it important that oral health leaders are involved?

Despite progress towards a more equitable health care system, oral health disparities persist.

• Untreated dental disease is disproportionately prevalent among racial and ethnic minorities
•  42 percent of African American adults and 36 percent of Hispanic adults have untreated dental disease, compared to 22 percent of Caucasians
• Among adults with incomes below the federal poverty line, 42 percent have tooth decay—that’s three times more than adults with incomes above 400 percent of the federal poverty line.
• Rural areas experience higher rates of dental disease and tooth loss with lower preventive utilization rates.
• Barriers such as cost and fear of discrimination mean just 10 percent of the surveyed LGBT population say they have regular dental visits.

With much progress still to be made, the four branches of the DentaQuest enterprise—benefits administration, philanthropy, science, and care delivery—will work in tandem to reduce inequities in the communities we serves across the country. This work not only enables us to get closer to achieving oral health for all, but also will drive our work with others.

Ultimately, our participation in this program steps up our ability to address health equity collaboratively with our partners – from states and clients to providers and patients.

National Minority Health Month: A Thank You to Community Health Promoters

During National Minority Health Month, we’re calling attention to barriers many people must overcome to enjoy their best health, and the advocates who help them. 

One of our jobs as a leading health care organization is to help people understand what they need to do to stay healthy – and that starts with literacy.

Literacy skills are one of the strongest predictors of oral health status – stronger than age, income, employment status, education level, or racial/ethnic group.  It is estimated that at least a third of adults in the United States have limited health literacy and nearly half of all American adults - 90 million people - have difficulty understanding and using health information. Because of that, folks delay taking action, and before long, small problems become big health issues.  

Community health workers are stepping in to help people understand and navigate our health care system. It’s a very personal approach to health education. DentaQuest’s outreach team spends a lot of time in the community talking to people about oral health and explaining dental benefits and how to use them. National Minority Health Month gives us an opportunity to talk about the importance of community health workers — promotores*, or  outreach specialists. These committed team members are doing incredible work to bridge health equity across communities.

Community outreach specialists are hyper grassroots, frontline public health translators. Using the strength of their personality; personal contacts; trust; and an intimate understanding of the community’s strengths, needs and social networks, they tackle sensitive health topics, correct misinformation, and connect people with quality care.  In some parts of the United States, our certified promotores are at work in rural and urban areas at clinics, churches, workplaces, schools, and even around agricultural fields.

These outreach specialists are very important to achieving our goal of ending dental disease in children. An estimated 17 million low income children in the United States go without oral health care each year—that’s about one out of every five children. 

Outreach workers help figure out why that happens. It might be because the families don’t know they should seek dental care for the children. It could be because the caregivers don’t know where to find a dentist. And it could be that the parents simply fear going to the dentist and share that fear with their kids. Outreach workers calm fears, educate and guide caregivers, and help them navigate the complexities of our health care system. They introduce families to preventive services, and even check back to be sure treatments that are initiated get completed.

And it’s not just for children. Regular screenings and preventive education for people of all ages reduce poor health outcomes and health expenditures. Outreach specialists help adults understand systemic health – what smoking does to the body or how managing mouth disease helps control diabetes and heart disease, for instance. It’s the trusting relationship with the community that enables outreach specialists to cross the cultural divide and get people involved in disease prevention and wellness. This is a critical role, especially where language, transportation and cultural responses are barriers to health.

National Minority Health Month - with this year's theme of health equity - is an opportunity to acknowledge the dedicated work of our promotores / outreach specialists and to give thanks for their genuine servicio de corazon (service from the heart).

Thank you for all you do to advance health equity nationwide!

*Promotores de salud, also known as promotoras, is Spanish for “community health worker.” 

Let's Talk Water Fluoridation this Children's Dental Health Month

In addition to Valentine’s and Presidents’ Days, February also marks National Children’s Dental Health Month, with a theme this year connected to fluoridation.

Dating back to February 1941, the month-long celebration brings together dental professionals, health care providers, educators, policymakers and more stakeholders to promote the benefits of good oral health for children through various activities and events.

This year’s campaign slogan is “Choose Tap Water for a Sparkling Smile,” focusing on the value of fluoridation.

Fluoride combines with enamel on the tooth’s surface to make it stronger, better able to resist decay, and prevent dental caries —the most common chronic disease for children.  

Over the years, research has supported the value of fluoridation:

• In 2013, the U.S. Task Force on Community Preventive Services found that on average fluoridated water increased the number of people in a community without dental caries by 25 percent. 

• A 2010 American Journal of Public Health article indicated that a child who consumes fluoridated water is less likely to have lost teeth from decay 40 to 50 years later in adulthood. 

Water fluoridation, since it requires passive action to show effect, offers a simple solution to contain total oral health expenditures, improve population health, and set children up to have better oral health as adults.

Water fluoridation benefits the entire community, regardless of status or background, which is critical to addressing ethnic, geographic, and socioeconomic barriers to effective oral healthcare—a widespread problem in the United States.

National Institutes of Health data indicates that 20 percent of White, non-Hispanic Americans have untreated tooth decay compared to 40 percent for Black, non-Hispanic Americans and 38 percent for Mexican Americans.

This data also showed that individuals below the federal poverty line (FPL) are almost three times more likely to have untreated decay compared to those making twice the FPL or above.

This makes dental disease a disease of disparities, which can be prevented, in part, by easy and free access to fluoride.

Fluoridated water is an evidence-based, cost-effective path to promote health equity and, as an oral health organization committed to improving the oral health of all, it is just another reason DentaQuest celebrates National Children’s Dental Health Month.

Why are dentistry and oral health care practices seemingly easy to question?

The topic of evidence in dentistry and oral health care has been in the news a lot recently, with articles like this column in the New York Times by a professor of pediatrics.

In his column, Aaron Carroll discusses the differences he sees between his own and his wife’s dental journeys, as well as what little rigorous research has been done to support certain generally recommended dental practices.

What is interesting is that articles like this one and the popular flossing article from the Associated Press, among others, imply that recommendations made by dentists are based solely on limited or weak evidence – or worse, based simply on what the dentist will get paid for by an insurance company.

They also leave readers feeling that plaque removal and cavity prevention/treatment are the only elements necessary to address for good oral health.

Ultimately, Carroll suggests in his column that while lack of evidence doesn’t mean oral health prevention efforts don’t work, we should invest in research to ensure that those things we do are evidence-based.

For those of us in the business of improving oral health, we couldn’t agree more with that conclusion. But let’s take a closer look at some of the points that may have gone overlooked by recent press coverage.

We know that evidence something works for populations doesn’t directly translate into solutions for a specific individual – that is in fact why Carroll and his wife have such dramatically different dental journeys.

Carroll notes he has had just one filling in his life and doesn’t religiously care for his mouth, while his wife has “more fillings than [he] can count” but is fastidious in her oral care routines.

This underscores two important points:

1. Every person is different. Individualizing care is critical to improved oral health.

While evidence-based research informs standards of care, it is the dental team that must develop the best care plan for any given person’s situation. That is why DentaQuest invests in the development and adoption of evidence-based care protocols that focus on prevention, early intervention and disease management.

Our investments in disease management and risk assessment help provide dental teams with the knowledge and tools they need to best serve their patients.

For instance, across a five-year period, the DentaQuest Oral HealthCenter demonstrated that risk assessment and intense preventive efforts (including sealants and fluoride varnish) directly resulted in a reduction in the need for invasive surgical procedures.

Sealants are one of the most cost-effective strategies for protecting teeth, as noted in another recent New York Times column. This is because they provide a physical barrier against cavities. They can even be applied to teeth that are just starting to show signs of new cavities, and stop them from getting bigger.

The best time to seal a tooth is immediately after it erupts in the mouth, and so the DentaQuest Oral Health Center strives to set aside extra time at visits for children ages 6 and 11 since the permanent molars are usually erupting at that time. It is also why the DentaQuest Foundation collaborates so closely with school-based health alliances working to improve access to oral health care – and sealants – among children in grade school.

Additionally, with a patient population of over 10,000, the DentaQuest Oral Health Center works in collaboration with the DentaQuest Institute to refine strategies that make patients healthier. And when these best practices are implemented, they actively improve peoples’ health.

2. Prevention and oral health improvement do not take place solely in the dental chair.

Preventive dental visits provide an important opportunity for people to check in on their oral health habits and get evaluations for early signs of not just dental disease, but also chronic diseases like diabetes and hypertension.

Most of us spend two hours a year in a dental office. And, if we are to reconsider the benefit of two annual preventive visits as Carroll suggests, some of us might end up spending even less time with a clinician. So what about the other 8,758 hours?

The differences in the oral health of Carroll and his wife are not because he brushes with an electric toothbrush every day or because she is doing something “wrong” in her routine. Oral health care is more than just brushing and flossing. In fact, it is about more than your teeth and gums.

To make an impact, we have to take a look at how we pay for oral health care, how our public policies enable it, and how our communities prioritize it, in addition to how we provide it.

Addressing just one of those will not improve oral health care on the larger scale or reduce health care costs, as Carroll aims to do with his recommendations. We know oral health care is indeed critical for overall health. This is why we at DentaQuest look far beyond the dental chair.

For example, as part of Oral Health 2020, the DentaQuest Foundation is investing in efforts to incorporate oral health into the primary education system. Oral health education, screenings, assisted referral, and delivery of preventive care through our schools provide equitable, reliable entry into long-term oral health care.

DentaQuest also champions efforts to include innovative financing models for dental in person-centered approaches to care enabled by the Affordable Care Act (ACA).

Over the last decade, we’ve seen significant movement to transform our health care system into one that improves quality, lowers costs, and makes people healthier. In fact, on the medical side the Triple Aim is starting to be supported by alternative payment and care delivery models that are person-centered and focus on prevention.

Why did that happen? Because experts and advocates knew there had to be a better way forward for a healthier America.

The same is true for oral health. We are beginning to see that it is possible to live in a world where optimal oral health is the expectation, not the exception. We must continue to invest the same transformative energy into improving the oral health of all because you cannot have optimal overall health without optimal oral health.

 

Let’s Focus on Quality, not Quantity

By Mark Doherty, DMD, Executive Director, DentaQuest Institute

It’s hard to miss the fact that our health care system is in the middle of a lot of change. I read about “pay for performance,” “accountable care organizations” and “value-based care” all the time. Oral health is not usually part of the discussion but that won’t be for long. The growing cost of care, the variation in treatments and care outcomes and the significant disparities faced by disadvantaged groups are important issues for dental care delivery too.

So I am very excited by the strong interest and motivation among my peers to find opportunities to focus on quality rather than quantity in America’s oral health care delivery system. I just returned from a meeting in Washington, D.C. with leaders in oral health and health care from across the care delivery spectrum (ADA, ADEA, CDHP, ADHA, CDC, HRSA, IHI, CMS, dental educators, providers, hospitals, health policy experts, insurers and more) where quality improvement and accountability were the central topics. Folks left the meeting ready to take part in this Quality Journey.

The impetus for the meeting was a new report (just released), edited by Paul Glassman DDS, MA, MBA, professor of dental practice and director of the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry. The report, Oral Health Quality Improvement in the Era of Accountability, is a call for a new dialogue on how to improve quality and increase access to affordable dental care.

Until now, the limited evidence of best practice for most dental procedures has led to widespread variation in clinical decisions among dentists; [Read the blog post, To Fill or Not to Fill by my colleague Dr. Doyle Williams to understand the variability in treatment approaches.] And today, there are few incentives to implement quality improvement programs.

But we need to. Dental expenses are now one of the highest out-of-pocket health costs for consumers. And 37 percent of African American children and 41 percent of Hispanic children have untreated tooth decay, compared to 25 percent of white children. The disparity is unacceptable.

Take a close look at the ideas in this report. We need to look at the opportunities to do better.

At the DentaQuest Institute, we’re emphasizing prevention and disease management in our quality improvement initiatives. The good news is that this approach works. When we apply a disease management model to the care of a chronic disease like Early Childhood Caries (ECC), we are seeing longer-term improvements in the patient’s oral health.

The DentaQuest Institute will post the presentations from the meeting in Washington on our website.

This is an exciting time for those of us who are passionate about better oral health for all.

A [Dental] Wake Up Call for Baby Boomers

Guest Post by Dr. Michael Monopoli, DentaQuest Foundation Director of Policy and Programs

The baby boom generation has consistently enjoyed better health and better oral health than any previous generation. Thanks to community water fluoridation, fluoride toothpastes and having dental insurance as part of employer-sponsored health plans, this generation is the first where a majority will keep and maintain their natural teeth over their entire lifetime.

This is wonderful news, and the facts support it. CDC data shows that over the past decade, the number of adults missing all their natural teeth has declined from 31 percent to 25 percent for those aged 60 years and older. And more good news: Seventy percent of adults at or above the poverty level said they visited a dentist in the past 12 months (CDC Fact Sheet). This is a generation that cares about and values its good oral health.

But there’s a serious dental wake-up call on the horizon for this first wave of boomer retirees. Even with largely good oral health, today’s retiring adults are realizing they will have to plan to pay largely out of pocket for dental care to maintain their oral health beyond their working years.

Many have all of their teeth and received routine dental care through their lives. They are now struggling with the realization that Medicare generally doesn’t cover routine dental procedures, such as cleanings or fillings. Medicaid, the jointly-funded Federal-State health insurance program for low-income people, funds dental care for low income and disabled elderly in a few states, but reimbursements are low. Most dental plans that cover the necessary services to maintain good oral health are based on employment and these dental benefits are lost with retirement. Retirees now have to figure out how they can continue the level of dental care they enjoyed through their working lives, and will need to balance these expenses along with other important needs like food, housing, and the rest.

And to add insult to injury, over the past decade, the value of retirement funds and IRAs has been shrinking with the ups and downs of the economy. Some retirees are facing the fact that their retirement funds may no longer support the lifestyle they were used to or hoped for – including good preventive health services.

It’s not a comfortable feeling to have to decide what dental care you are willing to pay for in order to have good oral health -- especially when we know good oral health is an integral part of overall health.

This is one of the issues that was discussed by the new U.S. National Oral Health Alliance, leaders from dentistry, medicine, dental education and the dental industry, health advocates, policy makers and philanthropy at their first leadership colloquium in 2011. Without access to oral health care and prevention, our nation’s most vulnerable families are at high risk. Many middle class elders will begin to face dental issues that our nation’s most vulnerable families have faced for many years. Hopefully, this larger group will change the conversation.

Best Wishes for Optimal Oral Health!

Grantees of the Oral Health 2014 Initiative, the DentaQuest Foundation's multi-year campaign to strengthen and accelerate state and community action on behalf of better oral health, met as a group for the first time on November 9 and 10 in Washington, DC. Grantees, advisors and DentaQuest Foundation staff gathered for an Oral Health 2014 group photo.

Building a Movement for Optimal Oral Health

By Ralph Fuccillo, President, DentaQuest Foundation

According to a recent report from the Institute of Medicine, “Millions of Americans are not receiving needed dental care services because of "persistent and systemic" barriers that limit their access to oral health care. Nearly 5 million children went without regular dental checkups in 2008 because of financial limitations. 33.3 million Americans live in an area with a shortage of dental professionals.” Improving Access to Oral Health Care for Vulnerable and Underserved Populations

Stories like this illustrate the need that drives the DentaQuest Foundation’s investments in oral health improvement at the national, state and local levels. Previously, I wrote about the DentaQuest Foundation’s support for the U.S. National Oral Health Alliance which is engaging national partners in oral health improvement goals.

People feel the pain of their inability to get needed services at the local level. So today, I am writing about the Oral Health 2014 Initiative. This new signature program of the DentaQuest Foundation is building a movement for oral health at the state and community level by supporting the work of state-based organizations that are developing effective community solutions.

When we announced the Oral Health 2014 initiative, we immediately saw a clear need and interest in community solutions for oral health across the United States. Over 200 program leaders from nearly every state joined in our Request for Proposals launch webinar in June. Seventy (70) organizations responded with their ideas. Thirty-six (36) were invited to submit a full proposal.

Today, Oral Health 2014 is taking root and moving forward in 20 states. I am enthusiastic about every one of these organizations. Each is working to build support for oral health solutions in their communities, engaging traditional and not-so-traditional partners. Oral Health 2014 is a multi-year initiative. The DentaQuest Foundation is committed to each organization’s success, providing financial and technical resources to help them move their projects forward.

This is an important moment for oral health. These 20 state organizations join the growing national movement of collaborative leaders who are aligned in their desire to address oral health disparities-- many hands working toward a common goal.

I extend the gratitude of the DentaQuest Foundation to the National Advisory Committee of leaders in community health, philanthropy, civic engagement, and members of the founding board of the U.S. National Oral Health Alliance. They provided guidance in the development of the program and the selection of grantees.

• Dr. Caswell Evans of the University of Illinois, DentaQuest Foundation Board of Directors and the U.S. National Oral Health Alliance Founding Board of Directors
• Paul Gilmer of Triana Energy and a member of the National Community Committee of the CDC Prevention Research Centers
• Dr. Leslie E. Grant of the National Dental Association and the U.S. National Oral Health Alliance Founding Board of Directors
• Marion Kane, formerly of Barr Foundation and currently on the Board of the Directors for the DentaQuest Foundation
• Dr. Dushanka Kleinman of the University of Maryland School of Public Health and the U.S. National Oral Health Alliance Founding Board of Directors
• Barbara Leonard of the Maine Health Access Foundation
• Sandra Owens Lawson of CRP Corp.
• Dr. Lindsey Robinson of the California Dental Association Foundation and the U.S. National Oral Health Alliance Founding Board of Directors, and
• Dr. Donna Shelley of New York University School of Nursing and Dentistry.

Congratulations to our new Oral Health 2014 partners! I encourage you to join them in building collaborative solutions.

The DentaQuest Foundation will continue to look for ways to support local leaders in their important work to make oral health a public health priority. We encourage every group who was interested in Oral Health 2014 to stay active as oral health advocates by contributing their talents and enthusiasm to the work of the U.S. National Oral Health Alliance which is tackling the same priority areas at the national level.

Our Community Health Champion!

The Boston Business Journal honored Dr. Mark Doherty, Executive Director of the DentaQuest Institute as a 2011 Health Care Champion for his work in expanding the reach of oral health care throughout Massachusett at the 2011 Champions in Health Care breakfast on August 26th.

Dr. Doherty has dedicated his career to expanding access to oral health services for low-income, underinsured and uninsured individuals in Massachusetts and across the country. During a long and illustrious career, Dr. Mark Doherty has been more than a dentist. He has also played the role of businessman, problem solver, oral health advocate, and mentor to other dentists who share his passion for improving the lives of underserved individuals.

When Dr. Doherty speaks about oral health, everyone listens, including lawmakers on Beacon Hill and Capitol Hill and federal agencies overseeing community health centers across the United States. Today, Dr. Doherty is working to create partnerships with community health center dental programs and training volunteer dentists who will mentor and coach community health center dental practice staff as they implement improvements to their practices.

Among many honors, Dr. Doherty was selected the 2011 Best Practice Management Consultant by Dr. Bicuspid readers who are dental professionals.

Prevention is Key

It was great to see the National Prevention Council’s recently released action plan for health prevention – but I couldn’t help but notice that there was no mention of the importance of oral health—at all.

Prevention is what helps us have good oral health vs. poor oral health. And prevention is all about understanding your risk factors and protective factors. This is true if you are a child or an adult.

In this Oral Health Matters blog, I try to get my readers to think about the risk factors—the things in your life which contribute to poor oral health. There are protective factors too and I’ll talk about them in another blog post. Right now, however, I’ll highlight some common risk areas. I hope you will read through them thoughtfully. If you say ‘yes’ to any of them, it is time to make an appointment with your dentist.

Common risk areas:

1. Not brushing and flossing your teeth every day – to remove food and bacteria. Making this part of your daily routine is a small change that pays big benefits.


2. Irregular visits to the dentist. I encourage visiting your dentist at least once a year. Why? Your dentist can detect early signs of trouble and help you get on track.


3. Have you had a cavity within the last 3 years? Have you lost teeth because of tooth decay or gum disease? Do you have puffy or bleeding gums, receding (shrinking) gums, or areas of the gum line where the root surface of the tooth is exposed? This could mean there may be active gum disease in your mouth. Your dental professional will want to watch you closely for this.


4. How is your health? Are you pregnant? Have you been diagnosed with diabetes? Do you use/abuse tobacco (cigarettes, pipes, cigars, chewing) or drugs? Do you regularly take prescription/over-the counter-medicines? Do you have braces or partial dentures? Are you undergoing chemotherapy or radiation therapy? Do you have an eating disorder? Do you have dry mouth? Each of these conditions puts you at higher risk for tooth decay or gum disease. Your oral health professional will help you make adjustments to keep your mouth healthy.


5. Are you a between-meal-snacker? Do you have a fondness for sugary foods? Do you drink a lot of soda or energy drinks? The sugars and acids in these foods/drinks can encourage tooth decay—especially if you let them linger in your mouth for hours. Again, your oral health professional can help you understand how to lower your risk of oral disease with things as simple as rinsing your mouth with water after eating to keep your teeth healthy.

Think about your answers to these questions and use them to start a conversation with your dentist about managing your areas of risk.

I would like to see Americans get smarter about the role of oral health in their overall health. That’s why I write this blog. When consumers have the knowledge to prevent problems and know when to seek care, they will likely be healthier. That’s why it is upsetting to me that oral health was missing from the National Prevention Council’s action plan.

I’d like to hear what you have to say on the importance of prevention. What does prevention mean to you?

Related Posts:

• Making Coverage Matter: Pew’s 50 State Report on Children’s Oral Health
• State of Oral Health In America Is Not So Good
• A New Chapter for Prevention
• Let’s Talk About the Oral Health of America’s Children
• Healthy Smiles in Miami Dade Schools

Sonrie!

Oral care in the United States is undergoing many significant changes. One of these is the exciting growth in the number of Hispanic dental practitioners and patients.

I just returned from the Hispanic Dental Association’s Annual (HDA) Roundtable in Plano, TX where I had the privilege of representing DentaQuest. HDA is a rapidly growing organization and the growth is expected to continue well into the 21st century. That’s a good thing because some experts are projecting a U.S. population that will soon be 40% Hispanic. Being able to talk to patients in a way that respects their culture and background is so important in providing the right care, at the right time, so we make a real impact.

The Hispanic Dental Association is playing a major role in building leadership for Hispanic oral health professionals during this time of change and it, like DentaQuest, is focused on prevention, treatment and education. DentaQuest and the DentaQuest Foundation are proud to support their work in improving oral health in the Hispanic population.

It was good to hear about the plans, concerns, needs and passion for dentistry among the member dentists. Several chapter presidents are DentaQuest providers. For me, this was an opportunity to explain the many facets of the DentaQuest enterprise’s commitment to improving oral health – our benefit programs, philanthropy, and clinical care improvement projects. I talked about the work we are doing to support dentists and their patients, to make participating in our networks easier, and to make sure oral health providers can deliver the best care outcomes. The dentists at the Roundtable were very interested in DentaQuest’s dental home project, our broken appointment project, and the many ways our website makes their work easier.

The dentists I met are enthusiastic champions for good oral health. They are hopeful that we will continue to support their meetings with our presence and are anxious to work with the DentaQuest Institute to improve cultural competency at the practice level. I believe that we have a very effective partnership developing. But for any effort like this to truly be successful we will need the partnership to extend to patients as well. Patients can and should play an important role. I’d like to hear from you on your thoughts.

Sip Safely

Spring and summer are a time of sports and hot, humid weather which leads to very thirsty kids. That often translates into an increase in the consumption of sugary and acidic sports drinks. These seemingly harmless liquids can actually wreak havoc on children’s teeth.

The combination of acidic components, sugars, and additives in sports drinks combine to erode the tooth’s surface, weakening the enamel that protects teeth from bacteria. The enamel erosion ultimately makes teeth more susceptible to bacteria and leads to hypersensitivity, staining, and tooth decay.

Frequent consumption of sports drinks lowers the pH in the mouth promoting the demineralization of tooth enamel. (The lower the pH, the more acidic the item.) Demineralization is caused primarily by stable acids found in acidic foods and drinks or which form as by product from bacteria feeding on starches and sugars in the mouth, especially refined sugars.

Demineralization begins at a pH level of 5.5 although under certain conditions, may even start at a higher pH. Popular sports drinks can have a pH of 2.4 and contain 5.5 tsp of sugar in a 12 oz can. So, not only does the drink have a pH that promotes demineralization, it also contains 5.5 tsp of sugar, which can independently contribute to demineralization and tooth decay.

To put the sports drink pH of 2.4 in perspective, compare it to battery acid, which has a pH of 0 and water, which has a pH of 5-7 (neutral). Shocking that a sports drink is closer on the pH scale to battery acid, than water.

Given all this, water is always the best option for everyone but the highest performing athletes who need to replenish minerals from intensive workouts.

If these facts haven’t convinced you to avoid the casual consumption of sports drinks, here are a few tips to keep in mind:

Don’t sip the drink throughout the day. - Drinking them for short periods of time means less time for the sugars and acids to erode enamel. Rinse your mouth with water when you’re done to clear away remaining acids and sugars.

Don’t swish the drink around your mouth. - That only increases the risk of erosion. Instead, use a straw so teeth aren’t immersed in or in direct contact with the sugars and acids in the beverage.

Resist the urge to brush your teeth immediately after finishing a sports drink. - Tooth enamel softens after consumption of acidic drinks, making teeth susceptible to more wear from the abrasives in toothpaste. Wait 45 minutes to an hour before brushing to give your saliva time to re-mineralize the tooth structure and neutralize the damage.

Seek regular dental care. - Tooth decay is the most common chronic childhood disease, five times more common than asthma. It’s also preventable with proper care. Your dentist can identify early signs of erosion, pinpoint the causes, and advise you on how to prevent further damage and more serious problems from occurring.

Maryland Dental Action Coalition Launches 5-Year Oral Health Plan

On May 17, the Maryland Dental Acton Coalition proudly presented a 5-year (2011-2015) state plan to promote the oral health of all Marylanders. The plan addresses Maryland’s most critical oral health needs and capitalizes on available resources and data.

Speaking at the celebratory launch event is The Honorable Elijah Cummings, U.S. Congress, a long time supporter of oral health access for children in Maryland and across the United States. Also speaking are Delegate Keith Haynes, Maryland General Assembly, Renee Cohen on behalf of the Honorable Ben Cardin, U.S. Congress, Josh Sharfstein, Secretary, Department of Health and Mental Hygiene, Joseph and Madeline Misero, Katrina Holt, Chair, MDAC Maryland Oral Health Plan Committee, and Beth Lowe, Chair, MDAC. Also speaking is Ralph Fuccillo, President of the DentaQuest Foundation, which provided start up grant funds to MDAC.

Maryland has become a national model in improving the oral health of its citizens over the last decade. The roots of this process go back to 2007, following the untimely death of a 12-year old Maryland child from an untreated dental infection. A statewide Dental Action Committee (DAC) was convened by John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene (DHMH), with a specific charge to make recommendations to improve access to oral health care for vulnerable (disadvantaged and/or underinsured) children.

In 2010, the DAC transitioned to the Maryland Dental Action Coalition (MDAC), an independent, broad-based partnership of individuals working to make sure progress continued on the DAC’s recommendations for improving access to oral health care for all Marylanders. Last year, MDAC hosted an Oral Health Heroes Celebration to recognize the work of these oral health pioneers.

The Maryland Dental Action Coalition and its members initiated the development of a 5-year state oral health plan and offered guidance as it was developed. The process involved many individuals in state and local government, academic institutions, professional dental organizations, private practice dentists, community-based programs, the insurance industry, advocacy groups, and others. The goals, objectives and activities in the plan will be the basis for work of the Maryland Dental Action Coalition in the years ahead specifically for:
• Access to oral health care
• Oral disease and injury prevention
• Oral health literacy and education.

With the launch of the plan comes a new phase of collaborative action to improve oral health for Marylanders. MDAC is taking inspiration from Helen Keller, who once said, “Alone we can do so little; together we can do so much!”

A copy of the Maryland Oral Health Plan will be posted to the DentaQuest Foundation website in Reports: www.dentaquestfoundation.org/resources/reports.php

Eliminating Disparities; Promoting Health Equity

Pictured:
Dr. Chester W. Douglass, Harvard University School of Dental Medicine and Harvard School of Public Health and Dr. Philip Woods, Periodontist and Reede Scholar.


Guest blog post by Ralph Fuccillo, President, DentaQuest Foundation

The DentaQuest Foundation was honored to sponsor the Reede Scholars 2nd Annual Health Equity Symposium held at Harvard Medical School on May 12, 2011. An audience of more than 75 leaders among the health professions, including community programming, health delivery systems, health plans and purchasers, large employers, government leaders, and health policy experts attended.

Reede Scholars are health care professionals (physicians, psychiatrists, psychologists and dentists) who are working from the grassroots level to the national level, in business, academia and government. This makes for a powerful network of individuals with numerous and varied talents, experiences and interests -- all focused on improving the health and well-being of underserved populations and racial/ethnic minorities.

The program is named to honor its creator and mentor, Dr. Joan Y. Reede, a pioneer in efforts to improve the representation of ethnic minorities in health services careers and founder of the Minority Health Policy Fellowship. Dr. Reede is an inspiration for thousands who seek to make a difference in the health of their communities. Reede Scholars are advancing public health goals that aim to remedy the root causes of poor health, chronic illnesses, morbidity and death and encouraging greater civic participation and support for improved health, community empowerment, and health equity.

The 2011 Health Equity Symposium explored Health Information Technology (HIT) as an approach to achieving health equity. Dr. David Blumenthal, the National Coordinator for Health Information Technology under President Barack Obama, spoke about the potential of health information technologies as a tool providers can use to better understand the socio-demographics of their patients and monitoring for disparities. Properly used, HIT has the potential to provide a rich and consistent profile of the patient to all his/her providers (medical, behavioral, oral health) not just for diagnosis but also as a point of engagement for patient education and lifestyle improvements.

Often, problems with access to dental care can be linked to the insufficient number of dental and medical provider groups with the experience and training to offer culturally competent care to the population as it is now. Investing in educational programs to diversify the student pool and provide consistent quality experiences outside of traditional clinics is nothing less than investing in the future. Sponsorship of the Reede Health Equity Symposium is one example of DentaQuest’s investments in public health dentistry, health equity and eliminating disparities.

DentaQuest shares the commitment that the return on these investments continue to add new professionals who enter public and private practice with the cultural sensitivity and training to meet the needs of the population as it is now and as it will change.